Acoustic assessment of dysphonia: Current practice and future directions - A narrative review

Auditory-perceptual judgment remains the clinical gold standard for characterizing dysphonia; however, its inherent subjectivity has motivated the search for objective acoustic correlates. This narrative review synthesizes the historical and methodological progression of voice acoustics from early time-domain perturbation measures (such as jitter and shimmer) and various implementations of the harmonics-to-noise ratio toward cepstral-spectral analysis capable of robust assessment of connected speech. We summarize the rationale and evidence underpinning cepstral peak prominence and multivariate indices and their validation across languages. We also addressed practical implementation issues, including acquisition prerequisites and software availability. Contemporary cepstral-spectral frameworks and multivariate composites offer clinically useful discrimination and responsiveness, positioning acoustic analysis as a practical adjunct for screening, monitoring, and guiding the treatment of voice disorders.